{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T05:13:31Z","timestamp":1766812411520,"version":"3.48.0"},"reference-count":15,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Survivors of sudden cardiac arrest frequently experience long-lasting problems with fatigue, cognition and mood. European Resuscitation Council (ERC) guidelines recommend functional assessment of physical\/non-physical issues prior to discharge, and systematic review within three months covering at least cognition, mood, fatigue, and support for patients and their families. How these recommendations are implemented and what barriers are encountered in routine care remains unknown. Methods: We conducted a multicentric, prospective 6-month audit across four tertiary cardiac-arrest centres in England where temporarily funded follow-up pathways were in place. Five operational criteria were developed based on ERC guidelines. Adherence was quantified, and reasons for non-completion were collected and mapped onto the Theoretical Domains Framework (TDF) to identify behavioural and contextual factors influencing implementation. Results: A total of 143 OHCA survivors were discharged alive. Pre-discharge assessments were offered to 116\/143 patients (81%) but only completed in 81 (57%). Reasons for non-completion included early discharge, severe cognitive impairment and, less frequently, patient refusal. Of 132 survivors eligible for follow-up, 108 (82%) were contacted and 87 (66%) attended. Only 25% of follow-ups occurred within the recommended 3-month period (median 185 days, IQR 81\u2013225). Among those seen, assessments were completed for cognition (44%), mood (52%), and fatigue (51%). Reasons for omission included patient refusal, clinical discretion, and time constraints. Survivors\u2019 family members were invited in all cases, but only 45% attended. Conclusions: Adherence to guideline-recommended assessments was variable and dependent on local practices, resource limitations, and patient\/clinician-related factors. Key barriers mapped to the TDF domains of \u2018Environmental context and resources\u2019, \u2018Beliefs about consequences\u2019 and \u2018Social influences\u2019. Structural policies excluding out-of-area and non-ICU patients, together with clinician judgement and patient engagement, were major determinants of implementation. These findings can guide targeted service development and support sustainable post-resuscitation care pathways.<\/jats:p>","DOI":"10.3390\/jcm15010174","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T23:52:27Z","timestamp":1766706747000},"page":"174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Translating Guidelines into Practice: A Multicentre Audit of the Implementation of ERC Survivorship and Follow-Up Recommendations After Cardiac Arrest"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3656-5965","authenticated-orcid":false,"given":"Marco","family":"Mion","sequence":"first","affiliation":[{"name":"Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon SS16 5NL, UK"},{"name":"Medical Technology Research Centre, Anglia Ruskin School of Medicine, Chelmsford CB1 1PT, UK"},{"name":"King\u2019s College Hospital, NHS Foundation Trust, London SW3 6PY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meadbh","family":"Keenan","sequence":"additional","affiliation":[{"name":"Barts Heart and Thorax Centre, St. Bartholomew\u2019s Hospital, London EC1A 7BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Steadman","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital, NHS Foundation Trust, London SW3 6PY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley","family":"Morrison","sequence":"additional","affiliation":[{"name":"Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon SS16 5NL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2747-777X","authenticated-orcid":false,"given":"Claudine","family":"Keelan","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUHFT), Norwich NR4 7UY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-9235","authenticated-orcid":false,"given":"Nikos","family":"Gorgoraptis","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London E1 1BB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilesh","family":"Pareek","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Metabolic Medicine & Sciences, BHF Centre of Excellence, King\u2019s College London, London SE5 8AF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Davis","sequence":"additional","affiliation":[{"name":"Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon SS16 5NL, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0360-5122","authenticated-orcid":false,"given":"Uzma","family":"Sajjad","sequence":"additional","affiliation":[{"name":"Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon SS16 5NL, UK"},{"name":"Medical Technology Research Centre, Anglia Ruskin School of Medicine, Chelmsford CB1 1PT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8695-7994","authenticated-orcid":false,"given":"Thomas R.","family":"Keeble","sequence":"additional","affiliation":[{"name":"Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon SS16 5NL, UK"},{"name":"Medical Technology Research Centre, Anglia Ruskin School of Medicine, Chelmsford CB1 1PT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.resuscitation.2021.02.012","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: Post-Resuscitation Care","volume":"161","author":"Nolan","year":"2021","journal-title":"Resuscitation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E654","DOI":"10.1161\/CIR.0000000000000747","article-title":"Sudden Cardiac Arrest Survivorship: A Scientific Statement from the American Heart Association","volume":"141","author":"Sawyer","year":"2020","journal-title":"Circulation"},{"key":"ref_3","first-page":"e19","article-title":"British Cardiovascular Intervention Society Consensus Position Statement on Out-of-Hospital Cardiac Arrest 2: Post-Discharge Rehabilitation","volume":"17","author":"Mion","year":"2022","journal-title":"Interv. 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